Healthcare Provider Details

I. General information

NPI: 1134207582
Provider Name (Legal Business Name): LOU ANN GARTNER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 09/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 BRYANT ST ENDOCRINOLOGY/DIABETES DIVISION
BUFFALO NY
14222-2006
US

IV. Provider business mailing address

4511 HARLEM RD SUITE 202
AMHERST NY
14226-3822
US

V. Phone/Fax

Practice location:
  • Phone: 716-878-7262
  • Fax: 716-888-3827
Mailing address:
  • Phone: 716-839-6720
  • Fax: 716-839-6740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number171634
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: